The 'Hippocratic' Corpus

Content and Context

Elizabeth Craik

• Publisher: Routledge
• Year: 2014
• ISBN:
  9781317567882
• Edition: 1
• Topic: History
• Subtopic: Ancient History
• Index: History

The Hippocratic Corpus comprises some sixty medical works of varying length, style and content. Collectively, this is the largest surviving body of early Greek prose. As such, it is an invaluable resource for scholars and students not only of ancient medicine but also of Greek life in general.

Hippocrates lived in the age of Socrates and most of the treatises seem to originate in the classical period. There is, however, no consensus on Hippocratic attribution. The 'Hippocratic' Corpus examines the works individually under the broad headings:

• content - each work is summarised for the reader
• comment - the substance and style of each work is discussed
• context is provided not just in relation to the corpus as a whole but also to the work's wider relevance.

Whereas the scholar or student approaching, say, Euripides or Herodotus has a wealth of books available to provide introduction and orientation, no such study has existed for the Hippocratic Corpus. As The 'Hippocratic' Corpus has a substantial introduction, and as each work is summarised for the reader, it facilitates use and exploration of an important body of evidence by all interested in Greek medicine and society.

Elizabeth Craik is Honorary Professor at University of St Andrews and Visiting Professor at University of Newcastle, UK.

1 Acut. (περὶ διαίτης ὀξέων, de victu acutorum)

On Regimen in Acute Diseases A and B

Text

Littré 2 (1840), Acut. A 192–377, Acut. B 378–529; Ermerins 1 (1859), Acut. A 287–327, Acut. B 328–365 and Prolegomena LXXIII–LXXXV; Teubner 1 (Kühlewein, 1894); Loeb 2 (Jones, 1923b), Acut. A and Loeb 6 (Potter, 1988b), Acut. B; CUF 6. 2 (Joly, 1972/2003)

Preliminary note

The content of On Regimen in Acute Diseases A and B, Acut. A and Acut. B, here viewed as a single bipartite work, is separately transmitted in the Hippocratic manuscripts as two consecutive pieces, with the differentiation that the second is prefaced by the term νόθα ‘spurious’; hence the regular modern designation with the slanted abbreviations Acut. and Acut. Sp. or, by some critics, with Acut. and Acut. ‘Appendix’.

Littré’s chapter division is followed. Jones, Potter and Joly divide in shorter sections as follows:

Acut. A 1–3 = L. 1; 4–6 = L. 2; 7–9 = L. 3; 10–14 = L. 4; 15–17 = L. 5; 18–20 = L. 6; 21–25 = L. 7; 26–27 = L. 8; 28–35 = L. 9; 36–37 = L. 10; 38–44 = L. 11; 45–47 = L. 12; 48–49 = L. 13; 50–52 = L. 14; 53–57 = L. 15; 58–61 = L. 16; 62–64 = L. 17; 65–68 = L. 18;

Acut. B 1–2 = L. 1; 3 = L. 2; 4–5 = L. 3; 6 = L. 4; 7–8 = L. 5; 9–10 = L. 6; 11–14 = L. 7; 15–20 = L. 8; 21–23 = L. 9; 24–30 = L. 10; 31–34 = L. 11; 35 = L. 12; 36 = L. 13; 37–38 = L. 14; 39 = L. 15; 40 = L. 16; 41 = L. 17; 42–50 = L. 18; 51 = L. 19; 52 = L. 20; 53 = L. 21; 54 = L. 22; 55 = L. 23; 56 = L. 24; 57 = L. 25; 58 = L. 26; 59 = L. 27; 60 = L. 28; 61–62 = L. 29; 63 = L. 30; 64 = L. 31; 65 = L. 32; 66 = L. 33; 67 = L. 34; 68 = L. 35; 69 = L. 36; 70 = L. 37; 71= L. 38; 72 = L. 39.

Content (Acut. A)

It is conceded that, ‘The authors of the so-called Knidian Opinions have correctly written of the experiences of sufferers from individual diseases and of the outcome of some diseases’; but objected that they omit much of importance, that decisions on treatment are poor, and that treatment is restricted to purges, whey and milk. There is then modified praise for the revisers (of the Knidian Opinions) who had greater medical acumen in prescription, but criticism follows: all these writers of old overlooked the importance of regimen, and incorrectly supposed there to be a direct coincidence between individual diseases and particular names for them. (1)

It is suggested that attention should be paid to the medical art as a whole; that procedures should be performed correctly and better than by others; that acute diseases, those named pleurisy, pneumonia, phrenitis and kausos by the writers of old, and diseases related to them are the greatest test of the doctor, as they cause most deaths; also that laymen (ἰδιῶται) are unable to distinguish between good and bad doctors. (2)

It is opined that uncertainties in medicine should be explored, a key example being differing practices in prescription of barley-based treatments, as the existence of conflicting opinions in prescription discredits physicians, just as the existence of conflicting opinions in divination discredits seers; the question is important for preservation or restoration of health. (3)

The good qualities of ptisane, barley gruel, are summarised and guidance on administration, beneficial in cases of pleurisy, is outlined; the proper preparation of ptisane is described and the condition of the bletos is considered; the administration of barley drinks in conjunction with barley gruel is discussed. (4–6)

The treatment of pain in the side is prescribed as fomentations or, if appropriate, phlebotomy and purging to be followed by barley-based treatments; doctors who prescribe fasting at the start of disease are criticised, as the change imposed is too violent; it is stated that, in general, change in dietary habits is not beneficial and that even slight changes can have deleterious effects; the prevalence of error, with especial reference to change, in disease management and dietary prescription is criticised and through parallels it is suggested that change is bad not only in diet but in other bodily habits also. (7–12)

Change is said to be peculiarly important in acute diseases and to be managed as dictated. (13)

There is a sudden transition to the topic of drinks and discussion follows of different types of wine, of the qualities and effects of hydromel (honey in water), of the qualities and effects of oxymel (honey in vinegar) and of the effects of water. (14–17)

The benefits of baths are then discussed and part A ends abruptly. (18)

Content (Acut. B)

Kausos, presented in terms of cause, symptoms and treatment, is said to have two types. (1)

Treatments for acute diseases are said to be, according to circumstances, bloodletting, purging and fasting. (2)

Three serious conditions are presented in terms of cause, symptoms and treatment: one marked by swelling of the hypochondriac regions, one involving sudden loss of speech and one with ‘stoppage of breath’. (3–5)

Synanchos, said to have two forms, is discussed. (6)

There is discussion of the onset and progress of fever, both as pyretos and as kausos, presented in terms of symptoms and treatment. (7–8)

Various general observations are made: treatment is complex; odd-numbered and even-numbered days are significant; signs must be noted with a view to correct prognosis. (9)

Signs and prognosis in fevers are discussed in conjunction with symptoms and treatment; pleurisy and pneumonia are discussed in terms of symptoms, treatment and prognosis. (10–11)

The progress and outcome of several conditions are presented in terms of preferred treatments: dysentery, bilious fever and tetanos. (12–14)

Various general observations are made: diseases are resolved through bodily orifices; the drug hellebore is appropriate in certain specified cases but not in others; exertion is the cause of some troubles. (15–17)

The effects of eating and drinking are discussed in terms of maintaining and not changing habits; the effects of different drinks and number of daily meals are noted; the effects of particular foodstuffs such as garlic, cheese, pulses, silphium, goat meat and pork are observed. (18)

Several conditions are discussed: ‘dry cholera’, two species of dropsy, ‘hot belly’. (19–21)

The practice of treatment by regimen is described, with stress on the need for care; various symptoms requiring care and caution are indicated. (22–23)

General instructions are given on bloodletting and purging. (24–25)

Specific drugs or procedures are listed for particular conditions or particular purposes: for dropsy (26), for a nosebleed (27), as an emetic (28), to stitch the eyelid or – for haemorrhoids – the anus (29), for internal purulence (30), for dysentery (31), as eye salves (32, 33), for pains and fluxes (34), for a womb problem (35), for dropsy (36), as a copper and flour paste (37), as laxatives (38, 39).

Comment (Acut. A and Acut. B)

Erotian glosses words drawn from both parts, A and B, which he does not differentiate. It is apparent from his preface that Erotian knows the composite work as περὶ πτισάνης On Barley Gruel and it has a place in his group on therapy by regimen. This same title is found in several manuscripts, as is the further alternative title πρὸς τὰς Κνιδίας γνώμας or δόξας Against the Knidian Opinions. Athenaios too knows the title On Barley Gruel (Athen. 2. 45, 2. 57), as does Galen; see also Ep. 21 [9. 388–390 L.]. These early titles, coexisting in the ancient tradition with the now canonical On Regimen in Acute Diseases, are evidence both of the general fluidity in use of titles and of the tendency to label a treatise from some content at its start (in this case, issues with the Knidians) or from some of its central concerns (in this case, instructions on making and prescribing barley gruel). Both problems – that of the relationship between the two parts of On Regimen in Acute Diseases and that of the most appropriate, or earliest, title – are deeply rooted and intractable. However, these controversies have been somewhat exaggerated and distorted by notions of Hippocratic authenticity and of true Hippocratic doctrines. Galen, who wrote an extended commentary on the treatise, was influential in regarding B as old but inauthentic, that is, unworthy of Hippocrates according to his perception (Hippocratis de acutorum morborum victu liber et Galeni commentarius 15. 418–919 K. = CMG 5. 9. 1).¹

There are evident differences between A and B, most markedly in presentation. The manner of A is ordered, judicious and precise, whereas that of B is disjointed, jumbled and vague. In A, views are expressed in strongly personal terms, with use of first-person pronouns and verbal forms (as A 7, 8, 11), whereas there is no such personal focus in B. The sense and syntax of A are enhanced by the use of particles conveying emphasis or nuance (μήν, δή, δῆθεν, μάλα μὲν οὖν), whereas that of B is more spare and lacking in sophistication. From the subject matter also, it is clear that B is not a natural continuation of A: we pass from a well-organised and coherent presentation of related therapeutic strategies in acute diseases to a concatenation of topics relating to such diseases, with only a loose relation to one another and to what precedes. The main theme of A is the general value, proper preparation and appropriate administration of barley preparations (ῥυφήματα): solid barley gruel (πτισάνη) or liquid barley infusion (χυλός) according to circumstances of both disease (periodicity and crisis) and sufferer (condition and constitution). Before antibiotics revolutionised the treatment of bacterial disease, the decoction of barley was a familiar and valued procedure and in the nineteenth century the author’s insights were eulogised.²

The rambling content of B ranges over the same acute diseases as A, with particular emphasis on the febrile condition kausos. Although B cannot be regarded as a continuation of A, nothing in the content of B directly contradicts the content of A; and some elements in B either repeat or amplify matter contained in A (as, with regard to meals, A 6 ~ B 7; A 9 ~ B 18). ...

Table of contents

• Cover
• Half Title
• Title Page
• Copyright Page
• Table of Contents
• Preface and acknowledgments
• List of abbreviations
• Map
• Introduction
• 1 Acut. (περὶ διαίτης ὀξέων, de victu acutorum) On Regimen in Acute Diseases A and B
• 2 Aer. (περὶ ἀέρων ὑδάτων τόπων, de aere, aquis, locis) On Airs, Waters and Places
• 3 Aff. (περὶ παθῶν, de affectionibus) On Affections
• 4 Alim. (περὶ τροφῆς, de alimento) On Nutriment
• 5 Anat. (περὶ ἀνατομῆς, de anatome) On Anatomy
• 6 Aph. (ἀφορισμοί, aphorismi) Aphorisms
• 7 Art. (περὶ τέχνης, de arte) On the Art
• Artic. See Fract., Artic.
• 8 Carn. (περὶ σαρκῶν, de carnibus) On Flesh
• 9 Coac. (Κῳακαὶ προγνώσιες, Coacae praenotiones) Koan Prognoses
• 10 Cord. (περὶ καρδίης, de corde) On the Heart
• 11 Decent. (περὶ εὐσχημοσύνης, de decenti habitu) On Decorum
• 12 Dent. (περὶ ὀδοντοφυίης, de dentitione) On Dentition
• Dieb. Iudic. See Iudic., Dieb. Iudic.
• 13 Epid. 1–7 (ἐπιδημιῶν, epidemiarum) Epidemics 1–7
• 14 Fist., Haem. (περὶ συρίγγων, de fistulis and περὶ αἱμορροίδων de haemorrhoidibus) On Fistulas and On Haemorrhoids
• 15 Flat. (περὶ φυσῶν, de flatibus) On Winds
• 16 Foet. Exsect. (περὶ ἐγκατατομῆς ἐμβρύου, de foetus exsectione) On Excision of the Foetus
• 17 Fract., Artic. (περὶ ἀγμῶν, de fracturis and περὶ ἄρθρων ἐμβολῆς, de articulis) On Fractures and On Joints
• 18 Genit., Nat. Pue (περὶ γονῆς, de genitura and περὶ φύσιος τοῦ παιδίου, de natura pueri) On Generation and On the Nature of the Child
• 19 Gland. (περὶ ἀδένων οὐλομελίης, de glandulis) On Glands
• Haem. See Fist., Haem.
• 20 Hebd. (περὶ ἐβδομάδων, de hebdomadibus) On Sevens
• 21 Hum. (περὶ χυμῶν, de humoribus) On Humours
• 22 Int. (περὶ τῶν ἐντὸς παθῶν, de internis affectionibus) On Internal Affections
• 23 Iudic., Dieb. Iudic. (περὶ κρισίων, de iudicationibus and περὶ κρισίμων, de diebus iudicatoriis) On Crises and On Days of Crisis
• 24 Iusj. (ὅρκος, iusiurandum) The Oath
• 25 Lex (νόμος, lex) The Law
• 26 Liqu. (περὶ ὑγρῶν χρήσιος, de liquidorum usu) On the Use of Liquids
• 27 Loc. Hom. (περὶ τόπων τῶν κατὰ ἄνθρωπον, de locis in homine) On Places in Man
• 28 Medic. (περὶ ἰητροῦ, de medico) On the Physician
• 29 Mochl. (μοχλικόν, mochlicum) Leverage
• 30 Morb. 1 (περὶ νούσων, de morbis 1) On Diseases 1
• 31 Morb. 2 (περὶ νούσων, de morbis 2) On Diseases 2
• 32 Morb. 3 (περὶ νούσων, de morbis 3) On Diseases 3
• 33 Morb. 4 (περὶ νούσων, de morbis 4) On Diseases 4
• 34 Morb. Sacr. (περὶ ἱερῆς νούσου, de morbo sacro) On the Sacred Disease
• 35 Mul. 1, 2, 3 (περὶ γυναικείων, de morbis mulierum and περὶ ἀφόρων, de sterilibus) On Diseases of Women 1, 2 and 3
• 36 Nat. Hom., Salubr. (περὶ φύσιος ἀνθρώπου, de natura hominis and περὶ διαίτης ὑγιεινῆς, de salubri diaeta) On the Nature of Man and On Regimen in Health
• 37 Nat. Mul. (περὶ γυναικείης φύσιος, de natura muliebri) On the Nature of Woman
• Nat. Pue. See Genit., Nat. Pue.
• Oct. See Sept., Oct.
• 38 Off. (κατ’ ἰητρεῖον, de officina medici) In the Surgery
• 39 Oss. (περὶ ὀστέων φύσιος, de ossium natura) On the Nature of Bones
• 40 Praec. (παραγγελίαι, praecepta) Precepts
• 41 Prog. (προγνωστικόν, prognosticum) Prognostic
• 42 Prorrh. 1 (προρρητικός, prorrheticus) Prorrhetic 1
• 43 Prorrh. 2 (προρρητικός, prorrheticus) Prorrhetic 2
• Salubr. See Nat. Hom., Salubr.
• 44 Sept., Oct. (περὶ ἑπταμήνου, de septimestri partu and περὶ ὀκταμήνου, de octimestri partu) On the Seven-month Infant and On the Eight-month Infant
• Steril. See Mul. 3
• 45 Superf. (περὶ ἑγκυήσιος, de superfetatione) On Superfetation
• 46 Ulc. (περὶ ἑλκῶν, de ulceribus) On Sores
• 47 VA (περὶ ὄψιος, de videndi acie) On Sight
• 48 VC (περὶ τῶν ἐν κεφαλῇ τρωμάτων, de vulneribus in capite) On Head Wounds
• 49 Vict. (περὶ διαίτης, de victu) On Regimen
• 50 Virg. (περἰ παρθενίων, de virginum morbis) On Diseases of Girls
• 51 VM (περὶ ἀρχαίης ἰητρικῆς, de vetere medicina) On Ancient Medicine
• Conclusion
• Glossary
• Bibliography
• Index of authors and texts
• General index